Dental News - Study shows both endoprosthesis surgeons and patients need more oral health training

Anisha Hall Hoppe, Dental Tribune International

Mon. 17. April 2023

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LEIPZIG, Germany: As any postoperative infection can potentially be linked to the oral cavity, researchers have evaluated the oral health, oral health knowledge and oral hygiene behaviours of patients in Germany scheduled for placement of endoprostheses (EP) to determine whether such patients receive adequate education on oral health and EP. Orthopaedic surgeons were also consulted about patient oral health and dental care in relation to EP. The findings suggest that a lack of interdisciplinary care is responsible for subpar patient oral hygiene behaviours and education.

The researchers, from the University of Leipzig and the University of Leipzig Medical Center, consulted EP patients prior to their procedures using a questionnaire to evaluate their oral hygiene behaviours and knowledge on oral health and the relationship between oral health and EP and to note any pre-existing oral health problems. They found that only 35.5% of the patients felt informed of the connection between oral health and EP. Only 25% had even informed their dentists about their planned EP procedure. Although 62.8% reported feeling educated about oral health overall, only half received regular professional tooth cleaning and 29.1% stated that they performed interdental cleaning, indicating extensive deficits in oral hygiene behaviours.

Only 14% of the orthopaedic surgeons reported contact with dentists, but there was little indication on whether any effort was made to consult dentists regarding evaluation and screening for oral health concerns prior to EP procedures. This is despite 92.8% of the surgeons reporting awareness of the relationship between EP infections and oral health.

The researchers also noted that, although current literature no longer recommends antibiotic prophylaxis prior to dental intervention, 76.0% of the orthopaedic surgeons surveyed recommended it, despite only 7.2% having knowledge of the recommended prophylactic drugs and dosages. The surgeons surveyed indicated that a standardised risk classification system for EP patients and guidelines on dental care prior to or after EP placement were important.

The survey results showed that the orthopaedic surgeons had little to no collaboration with dental care providers. The researchers thus suggested that the surgeons establish a pattern of preoperative dental referrals as an alternative to broad recommendations of antibiotic prophylaxis. They also suggested that there were systemic issues at play in that the separate education of dentists and physicians in Germany that appear to have resulted in significant knowledge gaps and divergent expectations that should be addressed at the level of undergraduate and postgraduate education regarding other medical fields.

The study, titled “Lack of oral health awareness and interdisciplinary dental care: A survey in patients prior to endoprosthesis and orthopaedic centres in Germany”, was published on 13 February 2023 in BMC Oral Health.